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تشک زخم بستر ( ضد زخم بستر )

افرادی که قادر به خارج شدن از رختخواب نیستند و یا به هر نحو و دلیلی قسمتهایی از بدنشان دائما تحت تماس و فشار با سطح زیرین است (مانند نشستن طولانی مدت بر روی ویلچیر) ممکن است دچار زخم بستر شوند، چون وزنشان دائما روی یک قسمت از بدن است و به همین خاطر ذخیره خون در آن قسمت بدن کاهش می‌یابد و در نتیجه بافت‌های بدن در آن قسمت می‌میرند و از بین می‌روند. انواع تشکها و زیراندازهای مواج ضد زخم بستر برای جلوگیری از ایجاد و یا درمان زخم بستر به کار میروند. با توجه به میزان و شدت، زخم های بستر در سه مرحله مختلف قابل تقسیم بندی میباشند. در مرحله یک پوست سالم است ولی قرمز شده و وقتی با انگشت به آن فشار میاوریم سریع سفید نمیشود. پوست ممکن است دردناک، سفت، نرمتر از معمول، سردتر یا گرم تر از معمول شود. در مرحله دو زخم بستر، لایه رویی پوست - اپیدرم - از بین میرود. یک زخم کمی فرو رفته به رنگ صورتی یا قرمز در محل تشکیل میشود و ممکن است در محل تاول تشکیل شود. زخمهای بستر درجه یک و دو با درمان مناسب میتوانند در عرض چند هفته بهبود یابند. درمان مراحل سوم و چهارم - که عارضه زخم حادتر و عمیق تر است - مشکل تر است.
عارضه زخم بستر بیشتر ممکن است در نواحی از بدن رخ دهد که فاصله بین استخوان و پوست نسبتا کم است. همچنین ایجاد زخم بستر تنها متوجه افرادی که به طور طولانی مدت بستری هستند و یا خوابیده اند (مانند موارد کما و یا نقاهتهای طولانی بعد از عمل) نیست. افرادی که دائما بر روی ویلچر نشته اند نیز ممکن است دچار عارضه زخم بستر شوند. بهترین راه جلوگیری از ایجاد زخم بستر استفاده از تشکهای مواج است. در مواردی برای درمان از پانسمانهای بدون منفذ نیز استفاده می شود (با نظر پزشک). رژیم غذایی مناسب و دریافت ویتامینهای لازم بدن نیز از جلوگیری و درمان زخم بستر بسیار حائز اهمیت است.
هنگامي كه بيمار در يك وضعيت به حد كافي طولاني مدت بنشيند يا بخوابد علائم و نشانه هاي آسيب پوست ناشي از فشار طولاني مدت ايجاد مي شود . همچنين اين علائم مي تواند با هر نوع از لخته ، يا اشياء سخت كه فشاربرروي پوست مي گذارد ايجاد شود . علائم اوليه شامل قرمز شدن ناحيه اي از پوست است و اگر فشار برداشته شود آسيب ايجاد نمي شود و قرمزي 15 دقيقه بعد از برداشتن فشار كم رنگ مي شود .


معمولا آسيب پوست ناشي از فشار در بالاي برجستگي هاي استخوان شروع مي شود مانند هر جايي از بدن كه استخوان با سطح پوست محصور شده است از قبيل استخوان لگن ، برجستگي هاي استخوان تمايل دارند فشار برروي پوست از داخل بگذارند يك سطح محكم بر روي سطح بيروني استخوان وجود دارد و پوست هنگامي بين سطح ثابت داخل استخوان و سطح ثابت بيروني قرار بگیرد رنگ پريده خواهد بود كه از فقدان جربان خون ناشي می شود .همچنين به علت كاهش ميزان جريان خون كه بدنبال آسیب نخاعی ايجاد مي شود اكسيژن كمتر در پوست وجود دارد كه در نتيجه مقاومت پوست پايين مي آيد و اگر پوست از اكسيژن به علت فشارمحروم شود بدن سعي خواهد كرد با فرستادن خون بيشتر به ناحيه جبران كند و ممكن است تورم پوست را نتيجه دهد و حتي فشار بيشتر بروي گردش خون خواهد گذاشت و جريان گردش خون بيشتر مسدود مي شود .



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